Effectiveness of structured comprehensive paediatric oral health education for parents of children less than two years of age in Germany

Abstract

Objective: To examine the effectiveness of expanding and improving oral health education in a clinical setting.

Research design: Controlled prospective intervention study.

Intervention: Structured comprehensive oral health education (SC-OHE) supported by written information. was performed by 36 clinicians in all of the 30 specialist paediatric practices in the city and the administrative district of Kassel, central Germany.

Participants: Parents of all children attending the practices for health examinations. SC-OHE was tested in two intervention groups (IG), one with a mean child age of seven months and another with a mean child age of 24 months. The SC-OHE content was adapted to the respective age groups. Control group (CG) subjects were recruited in a similar region in northern Germany and received conventional oral health education only. This consisted of comparable topics but was less comprehensive than SC-OHE. The two IGs comprised 2,170 children; the two age-matched CGs 2,040.

Outcome measures: Parental knowledge, attitudes and behaviour relevant to decreasing the risk of early childhood caries (ECC) development. The outcomes were measured by questionnaires sent to the parents.

Results: The response rate was 88%. On average, control group paediatricians provided 2.1 information items at each child examination whereas the intervention group provided 3.8 items. Parental knowledge increased by 23%. Self-efficacy and attitudes remained unchanged. 41% of 7-month-olds in the CG received baby bottles with cariogenic content during daytime as opposed to 32% in the IG (p < 0.001); however, bottle use at night was unchanged. IG parents were less likely to add sugar to puréed baby food of the 7-month-olds. In 24-month-old children, the frequent consumption of cariogenic beverages in the daytime decreased slightly (CG 66%, IG 61%, p < 0.001), but five other nutritional behaviours, fluoride use and tooth brushing remained unchanged.

Conclusions: Primary care providers can be trained to perform SC-OHE that improves parental oral health knowledge. SC-OHE provided by clinicians alone will not be capable of influencing crucial oral health behaviours in such a way that prevents ECC.